Ms ROXON (Minister for Health and Ageing) (6:22 PM)
—I thank the member for Page for her questions. The Minister for Ageing might want to address the more general question in terms of ageing. I thank her for her support for the infrastructure investments that are being made in the community. When you look at the whole health budget, we know that some of these relatively small grants can have a huge impact in smaller communities. I think that the reworking of the rural infrastructure grants—a change from the previous budget, but being delivered and enhanced now through this budget—has been a success story that we have seen results from quite quickly. I am pleased to hear that that is welcome and I am always interested in how our election commitments are being implemented and rolled out. I think Lismore will have a great integrated cancer service. The commitment in this budget to provide funding for 10 regional cancer services allows flexibility for existing services to apply to be enhanced and to be best practice regional services or for brand-new services to be provided and set up, particularly in areas where there is a lot of unmet need.

I, personally, am determined to address those quite depressing results of rural and regional Australians having far worse outcomes in cancer survival rates than their urban counterparts, and this is just part of us trying to turn around that trend. Some confidential consultations are going on at the moment with some specialists and stakeholders about the criteria in order to make sure that the process for the Health and Hospitals Fund is clear. We need to make sure that areas of need are properly identified but that we can also back good services that are already up and running and want to be enhanced and developed further. I know, for example, that the member for Riverina has already put her hand up to say that Wagga would be a great place to enhance their services. Similarly, I hear what the member for Page is saying, but it will be a process whereby we ask the Health and Hospitals Fund Advisory Board to assess the merits of each of the claims.

I thank her for the question about maternity services and nurse practitioners because this is a very big change announced in the health budget; a very significant change about the way we can best utilise our workforce into the future. It is important to recognise that very highly skilled midwives and nurse practitioners, who have master’s degrees and, often, years and years of experience, have been prohibited from the full scope of their practice because of some of the funding arrangements provided by previous governments. We think this is an important step into providing women, in particular, with the choices that they deserve around birthing. We also know that we have a very strong birthing system in Australia and, by and large, a very safe system, and we need to make these changes carefully.

The period of time between now and November next year, when these items will go onto the Medicare schedule, allows us to ensure that we get all the provider numbers right—because nurse practitioners and midwives, for the first time, will have Medicare provider numbers. It also ensures that we get the collaborative arrangements right so that midwives and nurses will have clear protocols for working with GPs or GP/obstetricians or obstetricians, and will have referral processes when situations are outside their scope of practice.

This is a way for us to provide safe care and more choice for women in our community, and I think it is long overdue. I am very pleased to hear that it is being well-received in your electorate, and I look forward to working with those in the community to see this change brought about. I also look forward to continuing to work with the states and territories on a national maternity services plan, where we will be asking the states to make sure that options—for example, more extensive birthing centres rather than the traditional hospital settings—are expanded in a range of hospitals across the country. This is the start of a change which could be quite significant, but will take time—maybe decades. If we do not start now, though, we will not see that change—which will be a significant benefit to women, not just in Page but around the country.